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1,296 results on '"Gurm, Hitinder S."'

202. Minimizing radiographic contrast administration during coronary angiography using a novel contrast reduction system: A multicenter observational study of the DyeVert™ plus contrast reduction system

Author

Gurm, Hitinder S., primary, Mavromatis, Kreton, additional, Bertolet, Barry, additional, Kereiakes, Dean J., additional, Amin, Amit P., additional, Shah, Atman P., additional, Hanzel, George S., additional, Rao, Siddhartha, additional, Thomas, Joseph L., additional, and Kumar, Gautam, additional

Published
2018
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203. Safety and efficacy of thrombectomy in patients undergoing primary percutaneous coronary intervention for Acute ST elevation MI: A Meta-Analysis of Randomized Controlled Trials

Author

Grossman P Michael, Hameed Irfan, Chetcuti Stanley, Tamhane Umesh U, Moscucci Mauro, and Gurm Hitinder S

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Clinical trials comparing thrombectomy devices with conventional percutaneous coronary interventions (PCI) in patients with acute ST elevation myocardial infarction (STEMI) have produced conflicting results. The objective of our study was to systematically evaluate currently available data comparing thrombectomy followed by PCI with conventional PCI alone in patients with acute STEMI. Methods Seventeen randomized trials (n = 3,909 patients) of thrombectomy versus PCI were included in this meta-analysis. We calculated the summary odds ratios for mortality, stroke, post procedural myocardial blush grade (MBG), thrombolysis in myocardial infarction (TIMI) grade flow, and post procedural ST segment resolution (STR) using random-effects and fixed-effects models. Results There was no difference in risk of 30-day mortality (44/1914 vs. 50/1907, OR 0.84, 95% CI 0.54-1.29, P = 0.42) among patients randomized to thrombectomy, compared with conventional PCI. Thrombectomy was associated with a significantly greater likelihood of TIMI 3 flow (1616/1826 vs. 1533/1806, OR 1.41, P = 0.007), MBG 3 (730/1526 vs. 486/1513, OR 2.42, P < 0.001), STR (923/1500 vs. 715/1494, OR 2.30, P < 0.001), and with a higher risk of stroke (14/1403 vs. 3/1413, OR 2.88, 95% CI 1.06-7.85, P = 0.04). Outcomes differed significantly between different device classes with a trend towards lower mortality with manual aspiration thrombectomy (MAT) (21/949 vs.36/953, OR 0.59, 95% CI 0.35-1.01, P = 0.05), whereas mechanical devices showed a trend towards higher mortality (20/416 vs.10/418, OR 2.07, 95% CI 0.95-4.48, P = 0.07). Conclusions Thrombectomy devices appear to improve markers of myocardial perfusion in patients undergoing primary PCI, with no difference in overall 30-day mortality but an increased likelihood of stroke. The clinical benefits of thrombectomy appear to be influenced by the device type with a trend towards survival benefit with MAT and worsening outcome with mechanical devices.

Published
2010
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205. Sodium bicarbonate-based hydration prevents contrast-induced nephropathy: a meta-analysis

Author

Tamhane Umesh, Tamura Akira, Ko Dennis T, Meier Pascal, and Gurm Hitinder S

Subjects
Medicine
Abstract

Abstract Background Contrast-induced nephropathy is the leading cause of in-hospital acute renal failure. This side effect of contrast agents leads to increased morbidity, mortality, and health costs. Ensuring adequate hydration prior to contrast exposure is highly effective at preventing this complication, although the optimal hydration strategy to prevent contrast-induced nephropathy still remains an unresolved issue. Former meta-analyses and several recent studies have shown conflicting results regarding the protective effect of sodium bicarbonate. The objective of this study was to assess the effectiveness of normal saline versus sodium bicarbonate for prevention of contrast-induced nephropathy. Methods The study searched MEDLINE, EMBASE, Cochrane databases, International Pharmaceutical Abstracts database, ISI Web of Science (until 15 December 2008), and conference proceedings for randomized controlled trials that compared normal saline with sodium bicarbonate-based hydration regimen regarding contrast-induced nephropathy. Random-effects models were used to calculate summary odds ratios. Results A total of 17 trials including 2,633 subjects were pooled. Pre-procedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of contrast-induced nephropathy (odds ratios 0.52; 95% confidence interval 0.34–0.80, P = 0.003). Number needed to treat to prevent one case of contrast-induced nephropathy was 16 (95% confidence interval 10–34). No significant differences in the rates of post-procedure hemodialysis (P = 0.20) or death (P = 0.53) was observed. Conclusion Sodium bicarbonate-based hydration was found to be superior to normal saline in prevention of contrast-induced nephropathy in this updated meta-analysis.

Published
2009
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210. Spectrum of atrial arrhythmias using the ligament of Marshall in patients with atrial fibrillation

Author

Chugh, Aman, primary, Gurm, Hitinder S., additional, Krishnasamy, Kavita, additional, Saeed, Mohammed, additional, Lohawijarn, Watchara, additional, Hornsby, Kyle, additional, Cunnane, Ryan, additional, Ghanbari, Hamid, additional, Latchamsetty, Rakesh, additional, Crawford, Thomas, additional, Jongnarangsin, Krit, additional, Bogun, Frank, additional, Oral, Hakan, additional, and Morady, Fred, additional

Published
2018
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212. Renal Complications in the Catheterization Laboratory, An Issue of Interventional Cardiology Clinics,

Author

Kooiman, Judith, Gurm, Hitinder S., Kooiman, Judith, and Gurm, Hitinder S.

Subjects
Kidneys--Diseases
Abstract

Interventional cardiologists are able to perform minimally invasive procedures, such as angioplasty and stenting, due to imaging technologies that allow them to see inside the heart and blood vessels without open surgery. Such imaging often requires injection of contrast media, which are generally safe, but for some patients with drug sensitivities or compromised kidney function, contrast-induced nephropathy (CIN) can result. CIN is a major complication that can increase in-hospital mortality. This issue of Interventional Cardiology Clinica addresses the management, treatment, and prevention of renal complications in the catheterization laboratory.

Published
2014

216. Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States

Author

Fanaroff, Alexander C., primary, Zakroysky, Pearl, additional, Dai, David, additional, Wojdyla, Daniel, additional, Sherwood, Matthew W., additional, Roe, Matthew T., additional, Wang, Tracy Y., additional, Peterson, Eric D., additional, Gurm, Hitinder S., additional, Cohen, Mauricio G., additional, Messenger, John C., additional, and Rao, Sunil V., additional

Published
2017
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217. The comparative safety of abciximab versus eptifibatide in patients on dialysis undergoing percutaneous coronary intervention: Insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)

Author

Sukul, Devraj, primary, Seth, Milan, additional, Schreiber, Theodore, additional, Hanzel, George, additional, Khandelwal, Akshay, additional, Cannon, Louis A., additional, Lalonde, Thomas A., additional, and Gurm, Hitinder S., additional

Published
2017
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218. Association Between Chronic Kidney Disease and Rates of Transfusion and Progression to End‐Stage Renal Disease in Patients Undergoing Transradial Versus Transfemoral Cardiac Catheterization—An Analysis From the Veterans Affairs Clinical Assessment Reporting and Tracking (CART) Program

Author

Vora, Amit N., primary, Stanislawski, Maggie, additional, Grunwald, Gary K., additional, Plomondon, Mary E., additional, Rumsfeld, John S., additional, Maddox, Thomas M., additional, Vidovich, Mladen I., additional, Woody, Walter, additional, Nallamothu, Brahmajee K., additional, Gurm, Hitinder S., additional, and Rao, Sunil V., additional

Published
2017
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219. Contrast‐induced nephropathy in patients undergoing endovascular peripheral vascular intervention: Incidence, risk factors, and outcomes as observed in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Author

Grossman, P. Michael, primary, Ali, Syed S., additional, Aronow, Herbert D., additional, Boros, Michael, additional, Nypaver, Timothy J., additional, Schreiber, Theodore L., additional, Park, Yeo Jung, additional, Henke, Peter K., additional, and Gurm, Hitinder S., additional

Published
2017
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223. Coronary artery perforations after contemporary percutaneous coronary interventions: Evaluation of incidence, risk factors, outcomes, and predictors of mortality

Author

Parsh, Jessica, primary, Seth, Milan, additional, Green, Jacqueline, additional, Sutton, Nadia R., additional, Chetcuti, Stanley, additional, Dixon, Simon, additional, Grossman, Paul M., additional, Khandelwal, Akshay, additional, Dupree, James M., additional, and Gurm, Hitinder S., additional

Published
2017
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226. Improving the Presentation and Understanding of Risk Models

Author

Stern, Ralph H., Smith, Dean E., and Gurm, Hitinder S.

Subjects
FOS: Computer and information sciences, FOS: Biological sciences, Applications (stat.AP), Quantitative Biology - Quantitative Methods, Statistics - Applications, Quantitative Methods (q-bio.QM)
Abstract

The key concepts (calibration, discrimination, and discordance) important in understanding and comparing risk models are best conveyed graphically. To illustrate this, models predicting death and acute kidney injury in a large cohort of PCI patients differing in the number of predictors included are presented. Calibration plots, often presented in the current literature, present the agreement between predicted and observed risk for deciles of risk. Risk distribution curves present the frequency of different levels of risk. Scatterplots of the risks assigned to individuals by different models show the discordance of the individual risk estimates. Increasing the number of predictors in these models produce increasingly disperse and progressively skewed risk distribution curves. These resemble the lognormal distributions expected when risk predictors interact multiplicatively. These changes in the risk distribution curves correlate with improved measures of discrimination., 14 pages, 7 figures

Published
2015

227. A Practical Approach to Preventing Renal Complications in the Catheterization Laboratory

Author

Aggarwal, Devika and Gurm, Hitinder S.

Abstract

Contrast-induced acute kidney injury is a common complication in patients undergoing invasive procedures and is associated with increased mortality and morbidity. There is no effective approach to the management of this complication, and prevention remains of paramount importance. The 3 pillars of prevention are identification of high-risk patients, appropriate hydration before and after contrast exposure, eGFR-based contrast dosing and use of ultra-low contrast volume in high-risk patients. Most evidence supporting these practices is derived from patients undergoing coronary angiography or percutaneous coronary intervention but these basic principles can be applied to most patients undergoing contrast-based procedures in the catheterization laboratory.

Published
2020
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228. Procedural Strategies to Reduce the Incidence of Contrast-Induced Acute Kidney Injury During Percutaneous Coronary Intervention.

Author

Almendarez, Marcel, Gurm, Hitinder S., Mariani, José, Montorfano, Matteo, Brilakis, Emmanouil S., Mehran, Roxana, and Azzalini, Lorenzo

Abstract

Contrast-induced acute kidney injury (CI-AKI) is a potentially serious complication following coronary angiography and percutaneous coronary intervention (PCI). The incidence of CI-AKI is particularly high in patients with advanced chronic kidney disease (defined as an estimated glomerular filtration rate <30 ml/min/1.73 m2). Although much effort has been dedicated to the identification and implementation of preventive measures for this complication at the pre-intervention stage, much less has been investigated on the procedural strategies and techniques to decrease the risk of CI-AKI during PCI. The mainstay of such approaches relies on the minimization of contrast volume by means of specific strategies or dedicated devices. Invasive imaging, such as intravascular ultrasound or non–contrast-based optical coherence tomography, is another pillar of any ultra-low-contrast-volume PCI protocol. Finally, an array of miscellaneous ancillary measures can be implemented to decrease the risk of CI-AKI, which includes the use of radial access, remote ischemic conditioning, and hemodynamic support in high-risk patients. The present review analyzes the technical aspects as well as the scientific evidence supporting these novel techniques, with the goal to improve the outcomes of patients at high risk for CI-AKI undergoing PCI. • The incidence of CI-AKI is particularly high (>25%) in patients with advanced CKD undergoing PCI, and has been associated with increased risk for in-hospital dialysis and mortality. • Implementing contrast-sparing protocols may reduce the risk for CI-AKI in patients with advanced CKD undergoing coronary angiography and PCI. • Additional components of an ultra-low-contrast-volume PCI protocol include strong reliance on intravascular imaging, device-based interventions, and ancillary measures. • Prospective (ideally randomized) studies should evaluate whether the implementation of the procedural recommendations discussed herein can lead to decreased rates of CI-AKI, need for dialysis, and mortality in high-risk patients undergoing PCI. [ABSTRACT FROM AUTHOR]

Published
2019
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241. Impact of institutional culture on rates of transfusions during cardiovascular procedures: The Michigan experience

Author

Likosky, Donald S., primary, Zhang, Min, additional, Paone, Gaetano, additional, Collins, John, additional, DeLucia, Alphonse, additional, Schreiber, Theodore, additional, Theurer, Patty, additional, Kazziha, Samer, additional, Leffler, Dale, additional, Wunderly, Douglas J., additional, Gurm, Hitinder S., additional, and Prager, Richard L., additional

Published
2016
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245. Using Propensity Score Matching in Clinical Investigations: A Discussion and Illustration

Author

Hosman, Carrie, Gurm, Hitinder S., Hosman, Carrie, and Gurm, Hitinder S.

Abstract

Propensity score matching is a useful tool to analyze observational data in clinical investigations, but it is often executed in an overly simplistic manner, failing to use the data in the best possible way. This review discusses current best practices in propensity score matching, outlining the method’s essential steps, including appropriate post-matching balance assessments and sensitivity analyses. These steps are summarized as eight key traits of a propensity matched study. Further, this review illustrates these traits through a case study examining the impact of access site in percutaneous coronary intervention (PCI) procedures on bleeding complications. Through propensity score matching, we find that bleeding occurs significantly less often with radial access procedures, though many other outcomes show no significant difference by access site, a finding that mirrors the results of randomized controlled trials. Lack of attention to methodological principles can result in results that are not biologically plausible.

Published
2015

246. Collaborative quality improvement vs public reporting for percutaneous coronary intervention: A comparison of percutaneous coronary intervention in New York vs Michigan

Author

Boyden, Thomas F., primary, Joynt, Karen E., additional, McCoy, Lisa, additional, Neely, Megan L., additional, Cavender, Matthew A., additional, Dixon, Simon, additional, Masoudi, Frederick A., additional, Peterson, Eric, additional, Rao, Sunil V., additional, and Gurm, Hitinder S., additional

Published
2015
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247. Reply

Author

Aragam, Krishna G., primary, Seth, Milan, additional, and Gurm, Hitinder S., additional

Published
2015
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